Precise correlation between MRI and histopathology - exploring treatment margins for MRI-guided localized breast cancer therapy.
ABSTRACT Magnetic resonance imaging (MRI) is more often considered to guide, evaluate or select patients for partial breast irradiation (PBI) or minimally invasive therapy. Safe treatment margins around the MRI-visible lesion (MRI-GTV) are needed to account for surrounding subclinical occult disease.
To precisely compare MRI findings with histopathology, and to obtain detailed knowledge about type, rate, quantity and distance of occult disease around the MRI-GTV.
Patients undergoing MRI and breast-conserving therapy were prospectively included. The wide local excision specimens were subjected to detailed microscopic examination. The size of the invasive (index) tumor was compared with the MRI-GTV. The gross tumor volume (GTV) was defined as the pre-treatment visible lesion. Subclinical tumor foci were reconstructed at various distances to the MRI-GTV.
Sixty-two patients (64 breasts) were included. The mean size difference between MRI-GTV and the index tumor was 1.3mm. Subclinical disease occurred in 52% and 25% of the specimens at distances ≥10mm and ≥20mm, respectively, from the MRI-GTV.
For MRI-guided minimally invasive therapy, typical treatment margins of 10mm around the MRI-GTV may include occult disease in 52% of patients. When surgery achieves a 10mm tumor-free margin around the MRI-GTV, radiotherapy to the tumor bed may require clinical target volume margins >10mm in up to one-fourth of the patients.
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ABSTRACT: The anatomy of intra-osseous vessels of bones distal to a femoral or an iliac arteriovenous fistula was studied by histologic and microangiographic methods. The venous and sinusoidal vessels were dilated and heavily filled with contrast medium from 3 to 60 weeks after construction of the fistula. The nutrient artery and its branches are smaller in caliber in bones distal to the fistula at three weeks but appeared to return to approximately normal size later in the experimental period. The anatomic findings appear to provide an important link in a hypothesis to explain the increase in total bone seen distal to an arteriovenous fistula.The Anatomical Record 10/1968; 162(3):255 - 267.
- Acta Anatomica 02/1961; 47:1-33.
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ABSTRACT: The intracortical canal/vessel systems of long bones are not yet completely understood in terms of their morphology and physiology, mainly because of the difficulty of injecting the small calibre vessels and cutting the calcified matrix. Here, we apply a novel method combining perfusion of the vessels and fracture of the cortical bone to enlighten the architecture of this system. The femurs of ten rabbits were perfused with a water-soluble dye (China ink) or alcoholic glycerol solution, and the fractured cortex specimens were then examined by scanning electron microscopy (SEM). The results document: (1) the fibrillar structure of the canal surfaces; (2) the perivascular environment with cellular components in different phases of incorporation within the bone matrix; (3) previously unreported filamentous structures on the outer surface of vessels, which could be interpreted as non-myelinic nerve fibres; (4) the inner organisation of the cutting cones. Although based exclusively on morphology, these observation have some relevance to increasing knowledge of bone circulation physiology in the cortical bone.Anatomical science international. 08/2009; 85(1):31-7.